Archive for September, 2009

Breaking Sen. Baucus

September 22, 2009

Senator Max Baucus of Montana will convene a meeting of the Senate Finance Committee today to discuss, amend and vote on his own health care overhaul plan. In the past few days news has been peppered with some of the changes and compromises that Baucus has considered for the bill, and issues on which he seems intent to hold steady.

Fellow senate Democrats and Olympia Snowe of Maine, the only remaining Republican, have raised two main issues with the bill.

First, Baucus’ proposal for the first time would require middle-income families to carry some sort of health insurance. Many within the committe believe that this may place too much pressure on families to purchase insurance they can’t afford. Baucus has not changed the requirement but conceded that he may reduce penalties for those without insurance.

Second, a main funding proponent of the proposal was Baucus’ plan to place a large excise tax on high-cost insurance policies. For Baucus and supporters, this would reduce overuse of medical services and deter insurance companies from

Problems with these funding measures stem from a number of circumstances. A big one is occupational, for instance it costs more to insure a firefighter than a software engineer for obvious reasons.

Whichever direction this week sees the committee go, one thing is clear: this bill is not the sweeping reform we once heard about.

Though controversial, it’s not surprising that some of the measures in question are the newest and perhaps brightest ideas. It has no provision for a government option to compete with private insurers. Non partisan sources project Baucus’ bill to actually subtract from the national deficit, but without the excise tax and penalties for uninsured middle-class, a large portion of that funding goes away.

Perhaps it’s true that some public servants and high-risk workers will foot the bill in terms of the excise tax, but it could be equally true that the tax would eventually drive down costs. The same could be said of the idea of having a much larger percentage of people covered by insurance plans. It’s the reason they were placed in the bill in the first place.

For all his effort and compromise over about a year, Baucus has barely gotten one Republican (Snowe) to consider supporting his bill. Attempts at bipartisanship are great, but perhaps they’ve been wasted here. We’re already pretty far off from the reforms we heard about just under a year ago, when talk was aggressive. We can ill afford to compromise and sterilize new reforms into complete uselessness.


Immigration and Healthcare Debates Meet Head On

September 15, 2009

The healthcare debate has grown a new limb, the issue of whether or not illegal immigrants will be able to recieve expanded health benfits on taxpayer money, and how this will be enforced. After the leader of a conservative immigration reform movement, the Federation for American Immigration Reform (FAIR) stirred the controversy, it has taken root in Washington. Starting this evening and tomorrow, conservative radio hosts will hold a “town hall of the airwaves” to highlight the costs of illegal immigration. Returning fire, liberal groups such as America’s Voice, have attacked FAIR, calling them fearmongerers and calling the founder out as a racist.

Again it seems as though congress has started to miss the point. As these two debates cross, not only does the scope of both debates expand (the result one would hope for), the scope of mortar shells the two sides can trade expands as well (the road we seem to be taking.) We’ve gone from a productive debate–what can be done about free riders on public healthcare benefits–to which side is more credible, which side has their hands the dirtiest, which side has the ugliest REAL motives.

The switch occurred without warning, and likely due to the normalcy of such an occurence, this switch seems to have gone unnoticed, or perhaps just accepted because of its entertainment value. Instead of debating what can be done about the problem of free riders who may not pay taxes and attempt to recieve public health benefits, America’s Voice and FAIR have decided to trade blows about who’s more of a racist xenophobe, while citing the other side as “mudlsingers” or “juvenile.” Once again a debate in congress seems deadlocked due to motives and feelings that should play no role in how we regulate the distribution of public health benefits.

Ugly Rumors, Uglier Truths

September 2, 2009

Healthcare reform has become possibly the most pressing issue on the Obama administration’s agenda. For the most part, both sides agree the present system should be changed, and that previous reforms have been nothing more than immediate responses to unique conditions as they have arisen. It is a debate that has been characterized by serious misunderstandings, partisan remarks and rumor spreading in congress.
The most recent of these rumors is highlighted in a hypothetical future situation former vice president candidate Sarah Palin presented on her Facebook page. In a brief post describing her fears about the policies in “the nationalized heath care plan that the current administration is rushing through congress,” Palin theorized about a panel of bureaucrats deciding the fate of her child with down syndrome based on the child’s assessed level of productivity.
“The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.”
It has since widely been affirmed that there is no provision for any such panel in any of the reforms proposed. The rumor stems from a mangled mix of the same partisan pundits who helped defeat the Clinton-era reforms, and ideas that the Obama administration supports a pro-abortion, pro-euthanasia program, and mixed-up accounts of legislation to provide for hospice care and “end of life” services. The debate the falsehood has sparked may be much more interesting that the rumor itself.
For me personally, the most shocking stories and the ones that tend to move me to push for serious reforms fast are the tales of woe from those who’ve experienced first-hand the horrors of managed care in a capitalist system. Those witout coverage, and those who believed their coverage was more than adequate, only to learn their provider would not support the treatment they needed. The Michael Moore film “Sicko” told several of these stories but presented one more interesting tale from a different perspective.
Linda Peeno was a physician in the Louisville area when she started working in managed care. Over time she came to be a medical reviewer for the Humana Group, later medical director at Blue Cross Blue Shield. In 1996 Linda gave horrifying testimony to congress about the pitfalls of managed care, and the Death Panels that were more than just partisan rumors. Peeno’s ‘96 testimony:
“I wish to begin by making a public confession: In the spring of 1987, as a physician, I caused the death of a man.

Although this was known to many people, I have not been taken before any court of law or called to account for this in any professional or public forum. In fact, just the opposite occurred: I was “rewarded” for this. It bought me an improved reputation in my job, and contributed to my advancement afterwards. Not only did I demonstrate I could indeed do what was expected of me, I exemplified the “good” company doctor: I saved a half million dollars.”
The idea that partisans inside and outside of congress would perpetuate such rumors as one about proposed ‘Death Panels’ is sad and it continues to widen the gap between both sides and delay any reform. The audacity of the rumor surpasses the shortsightedness politically into the territory of outright manipulation. As Peeno testified, her decision, or likely, decisions, saved the company $500,000, and that’s just the one time. Her organization stood to avoid losses of millions when medical boards denied coverage, where any such board—“Death Panel”—in the Obama plan would stand only to lose credibility and risk losing favor in public opinion.
I’d take a ‘Death Panel’ that answers to the people, rather than one that responds only to monetary incentives, any day.

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September 2, 2009

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